{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:06:28Z","timestamp":1789056388029,"version":"build-2803163510"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,27]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Peripherally inserted central catheters (PICCs) are frequently used in cardiac surgery patients to provide reliable long-term venous access for vasoactive medications, parenteral nutrition, and prolonged intravenous therapies. Although PICCs are associated with fewer complications than traditional central venous catheters, spontaneous catheter migration remains an uncommon but clinically important event that may lead to catheter malfunction or vascular injury.<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n We report the case of a 73-year-old man with multivessel coronary artery disease who underwent coronary artery bypass grafting \u00d73 with left atrial appendage ligation. A PICC placed preoperatively through the right basilic vein had its tip confirmed at the cavoatrial junction. On postoperative day 7, the patient developed haemodynamically unstable ventricular tachycardia following a prolonged coughing episode and underwent synchronized cardioversion. A chest radiograph obtained 6 h after prior confirmation of appropriate positioning demonstrated upward migration of the PICC tip into the right internal jugular vein. The catheter was removed and replaced without complication.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n This case highlights postoperative coughing and synchronized cardioversion as potential contributors to PICC migration in cardiac surgery patients and underscores the importance of reassessing catheter position following high-risk events to prevent complications related to catheter malposition.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag638","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:49:56Z","timestamp":1788954596000},"source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous PICC migration after cardiac surgery: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7042-3411","authenticated-orcid":false,"given":"John P","family":"Tsoumpelis","sequence":"first","affiliation":[{"name":"SUNY Upstate Medical University Department of Surgery, , 750 East Adams Street, NY 13210 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0541-4865","authenticated-orcid":false,"given":"Samuel J","family":"Martin","sequence":"additional","affiliation":[{"name":"SUNY Upstate Medical University Department of Surgery, , 750 East Adams Street, NY 13210 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Polomsky","sequence":"additional","affiliation":[{"name":"SUNY Upstate Medical University Department of Surgery, , 750 East Adams Street, NY 13210 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"2026091011102922200_ytag638-B1","volume-title":"StatPearls [Internet]","author":"Agarwal","year":"2025"},{"key":"2026091011102922200_ytag638-B2","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.12968\/bjon.2014.23.Sup19.S10","article-title":"ECG or X-ray as the \u2018gold standard\u2019 for establishing PICC-tip location?","volume":"23","author":"Oliver","year":"2014","journal-title":"Br J Nurs"},{"key":"2026091011102922200_ytag638-B3","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.2147\/TCRM.S156468","article-title":"The safety and accuracy of ECG-guided PICC tip position verification applied in patients with atrial fibrillation","volume":"14","author":"Gao","year":"2018","journal-title":"Ther Clin Risk Manag"},{"key":"2026091011102922200_ytag638-B4","doi-asserted-by":"crossref","DOI":"10.1016\/j.apjon.2024.100614","article-title":"Spontaneous migration of a peripherally inserted central catheter into the azygos vein and accidental transection during thoracic surgery: a case report","volume":"11","author":"Mao","year":"2024","journal-title":"Asia Pac J Oncol Nurs"},{"key":"2026091011102922200_ytag638-B5","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.ijnurstu.2013.10.021","article-title":"Incidence, risk factors and clinical outcomes of peripherally inserted central catheter spontaneous dislodgment in oncology patients: a prospective cohort study","volume":"51","author":"Qiu","year":"2014","journal-title":"Int J Nurs Stud"},{"key":"2026091011102922200_ytag638-B6","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1111\/1754-9485.12698","article-title":"Immediate post-insertion tip migration of peripherally inserted central catheters dependent on arm position and depth of inspiration","volume":"62","author":"De Carvalho","year":"2018","journal-title":"J Med Imaging Radiat Oncol"},{"key":"2026091011102922200_ytag638-B7","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1016\/S1051-0443(07)61308-6","article-title":"Change in peripherally inserted central catheter tip position with abduction and adduction of the upper extremity","volume":"11","author":"Forauer","year":"2000","journal-title":"J Vasc Interv Radiol"},{"key":"2026091011102922200_ytag638-B8","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s00408-020-00405-7","article-title":"Pulmonary complications of cardiac surgery","volume":"198","author":"Tanner","year":"2020","journal-title":"Lung"},{"key":"2026091011102922200_ytag638-B9","article-title":"A triad of shoulder injuries following cardioversion: a case report","volume":"16","author":"Tan","year":"2024","journal-title":"Cureus"}],"container-title":["European Heart Journal - 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